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			<div title="<h1>症状、一般情况</h1>" id="qqq">
					<table width="100%" border="0" align="center" cellpadding="0"
						cellspacing="0" class="content02">
						<tbody>
							<tr>
								<td colspan="4" class="zbt01" style="text-align: left">
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4" color="red">*</font><font size="4">姓名</font>
								</td>
								<td width="37%">
									<input id="" name="" type="text" class="srk200" value="" maxlength="50" />
								</td>
								<td align="right" width="13%">
									<font size="4" color="red">*</font><font size="4">体检日期</font>
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								<td width="37%">
									<input id="" name="" type="text" class="srk200" value="" maxlength="50" readonly="readonly" onFocus="WdatePicker()"/>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">体检单位</font>
								</td>
								<td width="37%">
									<input id="" name="" type="text" class="srk200" value="" maxlength="50" readonly="readonly"/>
								</td>
								<td align="right" width="13%">
									<font size="4" color="red">*</font><font size="4">责任医师</font>
								</td>
								<td width="37%">
									<input id="" name="" type="text" class="srk200" value="" maxlength="50" readonly="readonly" />
								</td>
							</tr>
							<tr>
								<td colspan="4" class="zbt01" style="text-align: left">
									<h2>症状</h2>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">症状</font>
								</td>
								<td colspan="3">
									<input id="Symptom_0" type="checkbox" name="Symptom" value="1" /><font size="4">无症状</font>
									<input id="" type="checkbox" name="Symptom" value="2" accept="1"/><font size="4">头痛</font>
									<input id="" type="checkbox" name="Symptom" value="3" accept="1"/><font size="4">头晕</font>
									<input id="" type="checkbox" name="Symptom" value="4" accept="1"/><font size="4">心悸</font>
									<input id="" type="checkbox" name="Symptom" value="5" accept="1"/><font size="4">胸闷</font>
									<input id="" type="checkbox" name="Symptom" value="6" accept="1"/><font size="4">胸痛</font>
									<input id="" type="checkbox" name="Symptom" value="7" accept="1"/><font size="4">慢性咳嗽</font>
									<input id="" type="checkbox" name="Symptom" value="8" accept="1"/><font size="4">咳痰</font>
									<input id="" type="checkbox" name="Symptom" value="9" accept="1"/><font size="4">呼吸困难</font>
									<input id="" type="checkbox" name="Symptom" value="10" accept="1"/><font size="4">多饮</font>
									<input id="" type="checkbox" name="Symptom" value="11" accept="1"/><font size="4">多尿</font>
									<input id="" type="checkbox" name="Symptom" value="12" accept="1"/><font size="4">体重下降</font>
									<input id="" type="checkbox" name="Symptom" value="13" accept="1"/><font size="4">乏力</font>
									<input id="" type="checkbox" name="Symptom" value="14" accept="1"/><font size="4">关节肿痛</font>
									<input id="" type="checkbox" name="Symptom" value="15" accept="1"/><font size="4">视力模糊</font>
									<input id="" type="checkbox" name="Symptom" value="16" accept="1"/><font size="4">手脚麻木</font>
									<input id="" type="checkbox" name="Symptom" value="17" accept="1"/><font size="4">尿急</font>
									<input id="" type="checkbox" name="Symptom" value="18" accept="1"/><font size="4">尿痛</font>
									<input id="" type="checkbox" name="Symptom" value="19" accept="1"/><font size="4">便秘</font>
									<input id="" type="checkbox" name="Symptom" value="20" accept="1"/><font size="4">腹泻</font>
									<input id="" type="checkbox" name="Symptom" value="21" accept="1"/><font size="4">恶心呕吐</font>
									<input id="" type="checkbox" name="Symptom" value="22" accept="1"/><font size="4">眼花</font>
									<input id="" type="checkbox" name="Symptom" value="23" accept="1"/><font size="4">耳鸣</font>
									<input id="" type="checkbox" name="Symptom" value="24" accept="1"/><font size="4">乳房胀痛</font>
									<input id="" type="checkbox" name="Symptom" value="25" accept="1"/><font size="4">其他</font>
									<div id="divsSymptomOther"><input id="" name="sSymptomOther" type="text" class="srk200" value="" maxlength="50"/></div>
								</td>
							</tr>
							<tr>
								<td colspan="4" class="zbt01" style="text-align: left">
									<h2>一般情况</h2>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">体温</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="50"/><font size="4">℃</font>
								</td>
								<td align="right">
									<font size="4">脉率</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" /><font size="4">次/分钟</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">呼吸频率</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="50" /><font size="4">次/分钟</font>
								</td>
								<td align="right">
									<font size="4">血压</font>
								</td>
								<td>
									<font size="4">左侧-</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50" />
									<font size="4">/</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50" /><font size="4">mmHg(收缩压/舒张压)</font>
									<br/>
									<font size="4">右侧-</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50" />
									<font size="4">/</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50" /><font size="4">mmHg(收缩压/舒张压)</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">身高</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="50" /><font size="4">cm</font>
								</td>
								<td align="right">
									<font size="4">体重</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" /><font size="4">kg</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">腰围</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="50" /><font size="4">cm</font>
								</td>
								<td align="right">
									<font size="4">体质指数(BMI)</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" /><font size="4">Kg/m2</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">老年人健康状态<br/>自我评估</font>
								</td>
								<td colspan="3">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">满意</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">基本满意</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">说不清楚</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="5"/><font size="4">不太满意</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">老年人生活自理能力<br/>自我评估</font>
								</td>
								<td colspan="3">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">可自理（0～3分）</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">轻度依赖（4～8分）</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">中度依赖（9～18分)</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="5"/><font size="4">不能自理（≥19分）</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">老年人认知功能</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">粗筛阴性</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">粗筛阳性&nbsp;&nbsp;总分：</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50" />
								</td>
								<td align="right">
									<font size="4">老年人情感状态</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">粗筛阴性</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">粗筛阳性&nbsp;&nbsp;总分：</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50" />
								</td>
							</tr>
						</tbody>
					</table>
			</div>
			<div title="<h1>生活方式、脏器功能</h1>">
				<table width="100%" border="0" align="center" cellpadding="0"
						cellspacing="0" class="content02">
						<tbody>
							<tr>
								<td colspan="4" class="zbt01" style="text-align: left">
									<h2>生活方式</h2>
								</td>
							</tr>
							<tr>
								<td align="right" width="12%">
									<font size="4">锻炼频率</font>
								</td>
								<td width="38%">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">每天</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">每周一次以上</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">偶尔</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">不锻炼</font>
								</td>
								<td align="right" width="11%">
									<font size="4" width="39%">每次锻炼时间</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" /><font size="4">分钟</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">坚持锻炼时间</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50" /><font size="4">年</font>
								</td>
								<td align="right">
									<font size="4">锻炼方式</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">饮食习惯</font>
								</td>
								<td colspan="3">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">荤素均衡</font>
									<input id="" type="checkbox" name="" value="2"/><font size="4">荤食为主</font>
									<input id="" type="checkbox" name="" value="3"/><font size="4">素食为主</font>
									<input id="" type="checkbox" name="" value="4"/><font size="4">嗜盐</font>
									<input id="" type="checkbox" name="" value="5"/><font size="4">嗜油</font>
									<input id="" type="checkbox" name="" value="6"/><font size="4">嗜糖</font>
									<input id="" type="checkbox" name="" value="7"/><font size="4">其他</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">吸烟状况</font>
								</td>
								<td colspan="3">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">从不吸烟</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">已戒烟</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">吸烟</font>
									<font size="4">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;日吸烟量：平均</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50"/>
									<font size="4">支&nbsp;&nbsp;开始吸烟年龄：</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50"/>
									<font size="4">岁&nbsp;&nbsp;戒烟年龄：</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50"/><font size="4">岁</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">饮酒情况</font>
								</td>
								<td colspan="3">
									<font size="4">饮酒频率：</font>
									<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">从不</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">偶尔</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">经常</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">每天</font>
									<br/>
									<font size="4">日饮酒量： 平均</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50"/>
									<font size="4">两&nbsp;&nbsp;是否戒酒 ：</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未知</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">未戒酒</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">已戒酒</font>
									<font size="4">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;戒酒年龄：</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50"/><font size="4">
									<font size="4">岁</font>
									<br/>
									<font size="4">开始饮酒年龄 ：</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="50"/>
									<font size="4">岁&nbsp;&nbsp;近一年内是否曾醉酒：</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未知</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">否</font>
									<br/>
									<font size="4">饮酒种类 ：</font>
									<input id="" type="checkbox" name="" value="1"/><font size="4">白酒</font>
									<input id="" type="checkbox" name="" value="2"/><font size="4">啤酒</font>
									<input id="" type="checkbox" name="" value="3"/><font size="4">红酒</font>
									<input id="" type="checkbox" name="" value="4"/><font size="4">黄酒</font>
									<input id="" type="checkbox" name="" value="5"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">职业病危害有无：</font>
								</td>
								<td colspan="3">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">有</font>
									&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
									<font size="4">（工种</font>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
									<font size="4">从业时间</font>
									<input id="" name="" type="text" class="srk70" value="" maxlength="25" />
									<font size="4">年）</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">毒物种类粉成</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">防护措施有无</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">放射物质</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">防护措施有无</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">物理因素</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">防护措施有无</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">化学物质</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">防护措施有无</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">其他</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">防护措施有无</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200" value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td colspan="4" class="zbt01" style="text-align: left">
									<h2>脏器功能</h2>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">口唇名称</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									<input id="" type="radio" name="" value="2"/><font size="4">红润</font>
									<input id="" type="radio" name="" value="3"/><font size="4">苍白</font>
									<input id="" type="radio" name="" value="4"/><font size="4">发干</font>
									<input id="" type="radio" name="" value="5"/><font size="4">皲裂</font>
									<input id="" type="radio" name="" value="6"/><font size="4">疱疹</font>
								</td>
								<td align="right">
									<font size="4">齿列名称</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									<input id="" type="radio" name="" value="2"/><font size="4">正常</font>
									<input id="" type="radio" name="" value="3"/><font size="4">缺齿</font>
									<input id="" type="radio" name="" value="4"/><font size="4">龋齿</font>
									<input id="" type="radio" name="" value="5"/><font size="4">义齿(假牙)</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">咽部名称</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									<input id="" type="radio" name="" value="2"/><font size="4">无充血</font>
									<input id="" type="radio" name="" value="3"/><font size="4">充血</font>
									<input id="" type="radio" name="" value="4"/><font size="4">淋巴滤泡增生</font>
								</td>
								<td align="right">
									<font size="4">视力</font>
								</td>
								<td>
									<font size="4">左眼</font>
									<input id="" name="" type="text" class="srk50" value="" maxlength="25" />
									<font size="4">右眼</font>
									<input id="" name="" type="text" class="srk50" value="" maxlength="25" />
									<font size="4">(矫正视力:左眼</font>
									<input id="" name="" type="text" class="srk50" value="" maxlength="25" />
									<font size="4">右眼</font>
									<input id="" name="" type="text" class="srk50" value="" maxlength="25" />
									<font size="4">)</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">听力</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									<input id="" type="radio" name="" value="2"/><font size="4">听见</font>
									<input id="" type="radio" name="" value="3"/><font size="4">听不清或无法听清</font>
								</td>
								<td align="right">
									<font size="4">运动功能</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									<input id="" type="radio" name="" value="2"/><font size="4">可顺利完成</font>
									<input id="" type="radio" name="" value="3"/><font size="4">无法独立完成其中任何动作</font>
								</td>
							</tr>
						</tbody>
					</table>	
			</div>
			<div title="<h1>&nbsp;&nbsp;查&nbsp;&nbsp;体&nbsp;&nbsp;</h1>">
				<table width="100%" border="0" align="center" cellpadding="0"
						cellspacing="0" class="content02">
						<tbody>
							<tr>
								<td colspan="4" class="zbt01" style="text-align: left">
									<h2></h2>
								</td>
							</tr>
							<tr>
								<td align="right" width="12%">
									<font size="4">眼底</font>
								</td>
								<td width="38%" colspan="3">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">正常</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">皮肤</font>
								</td>
								<td colspan="3">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">正常</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">潮红</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">苍白</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="5"/><font size="4">发绀</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="6"/><font size="4">黄染</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="7"/><font size="4">色素沉着</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="8"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right" width="12%">
									<font size="4">巩膜</font>
								</td>
								<td width="38%">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">正常</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">黄染</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">充血</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="5"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
								<td align="right" width="12%">
									<font size="4">淋巴结</font>
								</td>
								<td width="38%">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">未触及</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">锁骨上</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">腋窝</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="5"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">桶状胸</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">否</font>&nbsp;&nbsp;&nbsp;&nbsp;
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">是</font>
								</td>
								<td align="right">
									<font size="4">呼吸音</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">正常</font>&nbsp;&nbsp;&nbsp;&nbsp;
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">罗音</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">干罗音</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">湿罗音</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk150"	value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">心率</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" /><font size="4">次/分钟</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">心律</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">齐</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">不齐</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">绝对不齐</font>
								</td>
								<td align="right">
									<font size="4">杂音</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">腹部压痛</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">腹部包块</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">肝大</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">脾大</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">移动性浊音</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">下肢水肿</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">无</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">单侧</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">双侧对称</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="5"/><font size="4">双侧不对称</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">足背动脉搏动</font>
								</td>
								<td colspan="3">
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未触及</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">触及双侧对称</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">触及左侧弱或消失</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="4"/><font size="4">触及右侧弱或消失</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">肛门指诊</font>
								</td>
								<td colspan="3">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">未见异常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">触痛</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">包块</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">前列腺异常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="6"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">乳腺</font>
								</td>
								<td colspan="3">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">未见异常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">乳房切除</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">异常泌乳</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">乳腺包块</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="6"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">外阴</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">未见异常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">外阴</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">未见异常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">宫颈</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">未见异常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">宫体</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">未见异常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">附件</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">未见异常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">其他</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
						</tbody>
					</table>	
			</div>
			<div title="<h1>辅助检查</h1>">
				<table width="100%" border="0" align="center" cellpadding="0"
						cellspacing="0" class="content02">
						<tbody>
							<tr>
								<td colspan="4" class="zbt01" style="text-align: left">
									<h2></h2>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">血常规</font>
								</td>
								<td colspan="3">
									<font size="4">血红蛋白：</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">g/L &nbsp;&nbsp;白细胞：</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">×109/L &nbsp;&nbsp;血小板：</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">×109/L &nbsp;&nbsp;其他：</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">尿常规</font>
								</td>
								<td colspan="3">
									<font size="4">尿蛋白：</font>
									<input id="" name="" type="text" class="srk120"	value="" maxlength="25" />
									<font size="4">mg &nbsp;&nbsp;尿糖：</font>
									<input id="" name="" type="text" class="srk120"	value="" maxlength="25" />
									<font size="4">&nbsp;&nbsp;尿酮体：</font>
									<input id="" name="" type="text" class="srk120"	value="" maxlength="25" />
									<font size="4">&nbsp;&nbsp;尿潜血：</font>
									<input id="" name="" type="text" class="srk120"	value="" maxlength="25" />
									<font size="4">&nbsp;&nbsp;其他：</font>
									<input id="" name="" type="text" class="srk120"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right" width="12%">
									<font size="4">空腹血糖</font>
								</td>
								<td width="38%">
									<input id="" name="" type="text" class="srk120"	value="" maxlength="25" />
									<font size="4">mmol/L 或</font>
									<input id="" name="" type="text" class="srk120"	value="" maxlength="25" />
									<font size="4">mg/dL</font>
								</td>
								<td align="right" width="12%">
									<font size="4">心电图</font>
								</td>
								<td width="38%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">未见异常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">尿微量白蛋白</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
									<font size="4">mg/dL</font>
								</td>
								<td align="right">
									<font size="4">大便潜血</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">阴性</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">阳性</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">糖化血红蛋白</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
									<font size="4">%</font>
								</td>
								<td align="right">
									<font size="4">乙型肝炎表面抗原</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="2"/><font size="4">阴性</font>
									&nbsp;&nbsp;<input id="" type="radio" name="" value="3"/><font size="4">阳性</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">肝功能</font>
								</td>
								<td colspan="3">
									<font size="4">血清谷丙转氨酶:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">U/L&nbsp;血清谷草转氨酶:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">U/L&nbsp;白蛋白:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">mmol/L&nbsp;总胆红素:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">umol/L&nbsp;结合胆红素:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">umol/L</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">肾功能</font>
								</td>
								<td colspan="3">
									<font size="4">血清肌酐:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">μmol/L&nbsp;血尿素氮:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">mmol/L&nbsp;血钾浓度:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">mmol/L&nbsp;血钠浓度:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">mmol/L</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">血脂</font>
								</td>
								<td colspan="3">
									<font size="4">总胆固醇:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">mmol/L&nbsp;&nbsp;甘油三酯:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">mmol/L&nbsp;&nbsp;血清低密度脂蛋白胆固醇:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">mmol/L&nbsp;&nbsp;血清高密度脂蛋白胆固醇:</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="25" />
									<font size="4">mmol/L</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">胸部X线片</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">正常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">B超</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">正常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">宫颈涂片</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">正常</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">异常</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
								<td align="right">
									<font size="4">其他</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="25" />
								</td>
							</tr>
						</tbody>
					</table>	
			</div>
			<div title="<h1>中医体质辨识</h1>">
				<table width="100%" border="0" align="center" cellpadding="0"
						cellspacing="0" class="content02">
						<tbody>
							<tr>
								<td colspan="2" class="zbt01" style="text-align: left">
									<h2></h2>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">平和质</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未测评</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">基本是</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">平和质中医健康指导</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">饮食调养：均衡营养，粗精搭配</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">运动调养：坚持适度体育锻炼、气功、太极拳、五禽戏等</font>
									<br/>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">情志调养：性情豁达，心态平和</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">起居调养：早睡早起，居处安静</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">气虚质</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未测评</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">倾向是</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">气虚质中医健康指导</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">饮食调养：忌生冷，多食小米、粳米、牛肉、胡萝卜、香菇等，可常食用人参、莲子肉汤</font>
									<br/>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">运动调养：可适度散步，忌剧烈体育运动</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">情志调养：忌思虑</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">起居调养：避风寒，不宜过劳</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">阳虚质</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未测评</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">倾向是</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">阳虚质中医健康指导</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">饮食调养：多吃羊肉、猪肚、鸡肉、麻雀肉</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">运动调养：适度运动，不宜过劳</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">情志调养：保持心情舒畅</font>
									<br/>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">起居调养：早睡早起，注意保暖</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">其他调养：按摩足三里、气海、关元等穴位</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">阴虚质</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未测评</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">倾向是</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">阴虚质中医健康指导</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">饮食调养：慎食辛辣刺激性食品，多食蔬菜水果及龟、鳖等</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">运动调养：适合中小强度的锻炼</font>
									<br/>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">情志调养：静思、勿妄念</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">起居调养：早睡早起</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">其他调养：经常打太极、八段锦等，内练生津、咽津功</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">痰湿质</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未测评</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">倾向是</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">痰湿质中医健康指导</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">饮食调养：多食薏仁、莲子、赤小豆、冬瓜，慎肥甘辛辣</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">运动调养：适合做大强度，大运动量的锻炼</font>
									<br/>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">情志调养：少思寡欲、调息守神</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">起居调养：勿居住潮湿环境</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">湿热质</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未测评</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">倾向是</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">湿热质中医健康指导</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">饮食调养：忌食辛辣、忌酒，多食绿豆、苦瓜、赤小豆、莲藕等</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">运动调养：居住环境不能潮湿适合跑步、游泳、爬山、球类、武术等</font>
									<br/>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">情志调养：保持心情舒畅</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">起居调养：多听舒缓音乐</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">其他方法：可服用龙胆泻肝丸等</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">血瘀质</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未测评</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">倾向是</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">血瘀质中医健康指导</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">饮食调养：多食黑豆、黄豆、山楂、黑木耳等，少食苦瓜、蛋黄、虾</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">运动调养：多步行健身，适合做太极、五禽戏等</font>
									<br/>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">情志调养：保持心情愉快，培养良好兴趣，多与朋友交流</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">起居调养：早起早睡，居住环境安静</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">其他调养：可适当服用桂枝茯苓丸等</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">气郁质</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未测评</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">倾向是</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">气郁质中医健康指导</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">饮食调养：多食蘑菇、柑橘、佛手、洋葱、玫瑰花、少量饮酒</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">运动调养：多做户外活动，团队活动，不要一个人单独做运动游戏</font>
									<br/>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">情志调养：保持心情舒畅，学会发泄</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">起居调养：早睡早起，居住宽敞、明亮，衣着宽松</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">其他方法：可服用逍遥丸</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">特秉质</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未测评</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">是</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">倾向是</font>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">特秉质中医健康指导</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">饮食调养：忌生冷辛辣肥甘油腻及“发物”，避免接触致敏物</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">运动调养：参加力所能及的锻炼，增强体质</font>
									<br/>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">情志调养：志闲少欲，心安不惧</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">起居调养：居处不养宠物，春天不郊游</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">其他调养：可用玉屏风散等</font>
								</td>
							</tr>
						</tbody>
					</table>	
			</div>
			<div title="<h1>健康问题、治疗情况</h1>">
				<table width="100%" border="0" align="center" cellpadding="0"
						cellspacing="0" class="content02">
						<tbody>
							<tr>
								<td colspan="2" class="zbt01" style="text-align: left">
									<h2>现存主要健康问题</h2>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">脑血管疾病</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">缺血性卒中</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">脑出血</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">蛛网膜下腔出血</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">短暂性脑缺血发作</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="6"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50" />
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">肾脏疾病</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">糖尿病肾病</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">肾功能衰竭</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">急性肾炎</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">慢性肾炎</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="6"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50" />
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">心脏疾病</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">心肌梗死</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">心绞痛</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">冠状动脉血运重建</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">充血性心力衰竭</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="6"/><font size="4">心前区疼痛</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="7"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50" />
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">血管疾病</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">夹层动脉瘤</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">动脉闭塞性疾病</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50" />
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">眼部疾病</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">视网膜出血或渗出</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">视乳头水肿</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">白内障</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50" />
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">神经系统疾病</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未发现</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50" />
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">其他系统疾病</font>
								</td>
								<td width="87%">
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未发现</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">有</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50" />
								</td>
							</tr>
							<tr>
								<td colspan="2" class="zbt01" style="text-align: left">
									<h2>住院治疗情况</h2>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">住院史</font>
								</td>
								<td width="87%">
									<table border="0" id="wuborder">
										<tr>
											<td align="center"><font size="4">入院日期</font></td>
											<td align="center"><font size="4">出院日期</font></td>
											<td align="center"><font size="4">原因</font></td>
											<td align="center"><font size="4">医疗机构名称</font></td>
											<td align="center"><font size="4">病案号</font></td>
										</tr>
										<tr>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
										</tr>
										<tr>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
										</tr>
									</table>
								</td>
							</tr>
							<tr>
								<td align="right" width="13%">
									<font size="4">家庭病床史</font>
								</td>
								<td width="87%">
									<table border="0" id="wuborder">
										<tr>
											<td align="center"><font size="4">建床日期</font></td>
											<td align="center"><font size="4">撤床日期</font></td>
											<td align="center"><font size="4">原因</font></td>
											<td align="center"><font size="4">医疗机构名称</font></td>
											<td align="center"><font size="4">病案号</font></td>
										</tr>
										<tr>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
										</tr>
										<tr>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
										</tr>
									</table>
								</td>
							</tr>	
						</tbody>
					</table>	
			</div>
			<div title="<h1>用药情况、其他</h1>">
				<table width="100%" border="0" align="center" cellpadding="0"
						cellspacing="0" class="content02">
						<tbody>
							<tr>
								<td colspan="2" class="zbt01" style="text-align: left">
									<h2>主要用药情况</h2>
								</td>
							</tr>
							<tr>
								<td align="right" width="14%">
									<font size="4">主要用药情况</font>
								</td>
								<td width="86%">
									<table border="0" id="wuborder">
										<tr>
											<td align="center"><font size="4">药物名称</font></td>
											<td align="center"><font size="4">用法</font></td>
											<td align="center"><font size="4">用量</font></td>
											<td align="center"><font size="4">用药时间</font></td>
											<td><font size="4">服药依从性</font></td>
										</tr>
										<tr>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td>
												&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
												&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">规律</font>
												&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">间断</font>
												&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">不服药</font>
											</td>
										</tr>
										<tr>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td>
												&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">未检查</font>
												&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">规律</font>
												&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">间断</font>
												&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">不服药</font>
											</td>
										</tr>
									</table>
								</td>
							</tr>
							<tr>
								<td colspan="2" class="zbt01" style="text-align: left">
									<h2>非免疫规划预防接种史</h2>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">非免疫规划预防接种史</font>
								</td>
								<td>
									<table border="0" id="wuborder">
										<tr>
											<td align="center"><font size="4">名称</font></td>
											<td align="center"><font size="4">接种日期</font></td>
											<td align="center"><font size="4">接种机构</font></td>
										</tr>
										<tr>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
										</tr>
										<tr>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
											<td><input id="" name="" type="text" class="srk150"	value="" maxlength="50" /></td>
										</tr>
									</table>
								</td>
							</tr>	
							<tr>
								<td colspan="2" class="zbt01" style="text-align: left">
									<h2>健康评价</h2>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">是否有异常</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">体检无异常</font>
									<input id="" type="checkbox" name="" value="2"/><font size="4">有异常</font>
									<font size="4">&nbsp;&nbsp;异常1:</font>
									<input id="" name="" type="text" class="srk150"	value="" maxlength="50"/>
									<font size="4">异常2:</font>
									<input id="" name="" type="text" class="srk150"	value="" maxlength="50"/>
									<font size="4">异常3:</font>
									<input id="" name="" type="text" class="srk150"	value="" maxlength="50"/>
									<font size="4">异常4:</font>
									<input id="" name="" type="text" class="srk150"	value="" maxlength="50"/>
								</td>
							</tr>
							<tr>
								<td colspan="2" class="zbt01" style="text-align: left">
									<h2>健康指导</h2>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">健康指导</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">定期随访</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">纳入慢性病患者健康管理</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">建议复查</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">建议转诊</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">控制因素</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">戒烟</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="2"/><font size="4">健康饮酒</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="3"/><font size="4">饮食</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="4"/><font size="4">锻炼</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="5"/><font size="4">减体重</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="6"/><font size="4">建议接种疫苗</font>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="7"/><font size="4">其他</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50"/>
									<br/>
									<font size="4">减体重(目标)：</font>
									<input id="" name="" type="text" class="srk70"	value="" maxlength="50"/>
									<font size="4">&nbsp;&nbsp;&nbsp;&nbsp;建议接种疫苗：</font>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50"/>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">下次体检日期</font>
								</td>
								<td>
									<input id="" name="" type="text" class="srk200"	value="" maxlength="50"/>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">是否进行健康教育</font>
								</td>
								<td>
									&nbsp;&nbsp;<input id="" type="checkbox" name="" value="1"/><font size="4">是</font>
								</td>
							</tr>
							<tr>
								<td align="right">
									<font size="4">健康教育内容</font>
								</td>
								<td>
									 <textarea id="" style="width:800px;height:70px;font-size:18px;font-weight:bold;" name=""></textarea>
								</td>
							</tr>
							<tr>
								<td align="center" colspan="2">
									<div class="navk">
									<a href="###" class="easyui-linkbutton" plain="true" onclick="save()"><h1>&nbsp;&nbsp;保&nbsp;&nbsp;存&nbsp;&nbsp;</h1></a>
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							</tr>
						</tbody>
					</table>	
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